Abstract
US hospitals are required by Joint Commission to utilize a command structure that is compliant with the National Incident Management System (NIMS). Most utilized is the Hospital Incident Command System (HICS) which guides any disaster response. Further, hospitals are required to NIMS guidelines when responding to events that predicate the implementation of disaster plans or protocols - especially when hospital leaders will interact with local, state or federal authorities. These mandates have grown in depth and breadth since all first responder disciplines began to update their local policies, procedures, and education requirements in the post-9/11 preparedness environment. This new environment includes ongoing federal grants designed to increase hospital preparedness and capacity, but with the fund are mandates requiring hospitals to educate staff members in NIMS education and its use. As a result, many hospitals have adopted HICS and NIMS as the general frameworks on which they build disaster plans, education sessions, and disaster drills. While federal and state officials continue to track compliance with federal requirements, there seems to be a gap in tracking use and effectiveness of HICS and NIMS in real-life incidents, whether planned or emergent. This article examines the real-life experiences of one 1,000+ bed Michigan hospital system that used HICS and NIMS during responses to a state funeral, a credible bomb threat, and a helicopter crash
Highlights
As medical care and public health providers reflect on the start of the 21st century, they will consider a range of events that influenced their priorities, from post-hurricane relief to fear of terror attacks to the first declared avian flu pandemic since 1968, when H3N2 reportedly killed 700,000 people [1]
Among the organizations directly affected by these events and subsequent calls for enhanced disaster preparedness are the 2,849 non-government, not for profit community hospitals [3] - of which the Michigan healthcare system is one
Hospital Incident Command System (HICS) began in the late 1980s as the Hospital Emergency Incident Command System (HEICS) and evolved to HICS, which is “a comprehensive incident management system intended for use in both emergent and non-emergent situations” [4]
Summary
As medical care and public health providers reflect on the start of the 21st century, they will consider a range of events that influenced their priorities, from post-hurricane relief to fear of terror attacks to the first declared avian flu pandemic since 1968, when H3N2 reportedly killed 700,000 people [1]. Among the organizations directly affected by these events and subsequent calls for enhanced disaster preparedness are the 2,849 non-government, not for profit community hospitals [3] - of which the Michigan healthcare system is one. Though the hospital physicians and staff plan for disasters much like their peers, they have learned significant lessons from unique real-life experiences that include response to a presidential funeral, a credible bomb threat to one of its hospitals, and a medical helicopter rooftop crash
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